Obamacare insurance rates get final approval

The Connecticut Insurance Department has approved prices for health plans to be sold through Access Health CT, the new marketplace created by federal health reform.

The monthly premiums for plans sold through Access Health’s individual market range from $197 per month for a 21-year-old in Hartford County to $1,144 a month for a 64-year-old in Fairfield County. But that’s before taking into account federally funded discounts that many customers are expected to qualify for to lower their costs.

The costs a particular person would pay will vary based on age, location and the particular plan selected, as well as whether the person qualifies for a discount.

Between 80,000 and 100,000 people are expected to buy coverage for next year through Access Health, the state’s health insurance exchange. It will begin enrolling people Oct. 1 for coverage that takes effect Jan. 1.

The insurance department approved rates for three carriers to sell coverage through the exchange’s individual market, and finalized rates for three carriers offering coverage to small businesses.

Through the rate review process, the department required Anthem Blue Cross and Blue Shield to reduce its rates. Another carrier, newcomer HealthyCT, lowered its rates in advance of the department’s final decision. Both of those insurers will sell coverage on Access Health’s individual and small-group markets.

ConnectiCare Benefits, which will sell plans only on the exchange’s individual market, received approval for its rates as proposed. UnitedHealthcare, which will offer plans only on the exchange’s small-group market, reduced its rates during the review process.

Access Health CEO Kevin Counihan said his staff will be examining the rates but, in a statement, called them a positive sign.

“This is good news because our preliminary analysis indicates that many residents in Connecticut may actually see their insurance rates go down, while for those who may see increases, they will be far less than was predicted even just a few months ago,” he said.

So, what are the rates?

In addition to choosing between insurers, customers will have a choice of plan types, signified by metals. Bronze plans will have the lowest premiums, but will leave members with larger out-of-pocket costs when they get medical care. Gold plans will cost the most in premiums but will carry lower deductibles and copays. Silver plans fall in the middle.

The insurance department reported the base monthly premium rate for each insurer — that is, the starting point, before adjusting the figure up or down to account for a person’s age and location.

For bronze plans sold on the individual exchange, the base rates are: $236.59 for Anthem, $215.17 for ConnectiCare, and $245.45 for HealthyCT.

Silver plans on the individual exchange have higher base rates: $299.21 for Anthem, $269.66 for ConnectiCare, and $310.02 for HealthyCT.

Gold plans on the individual exchange have base rates of $346.91 for Anthem, $309.64 for ConnectiCare, and $321.22 for HealthyCT.

That’s the starting point. The number then gets adjusted based on a person’s age. A 21-year-old’s premium won’t vary at all from the base rate. A 64-year-old will pay three times as much.

Then the premium gets adjusted based on the county where the person lives. People in Fairfield County will face the highest rates, up to 11 percent higher than the base rate. By contrast, a Hartford County resident would pay 15 percent less than the base rate for an Anthem plan, and about 9 percent below the base rate for HealthyCT and ConnectiCare plans.

Some examples

So what does that mean?

Let’s say you’re a 21-year-old in Hartford County. The monthly cost for a bronze plan through the individual exchange would range from $197.40 from ConnectiCare to $224.83 from HealthyCT. A silver plan would cost between $247.39 (ConnectiCare) and $283.98 (HealthyCT) per month. And a gold plan would range from $284.06 to $297.96 (Anthem) each month.

For a 45-year-old in Hartford County, bronze plans would range from $285.05 (ConnectiCare) to $324.65 (HealthyCT). Silver plans would range from $357.23 (ConnectiCare) to $410.05 (HealthyCT) per month, while gold plans would cost between $410.18 (ConnectiCare) to $430.25 (Anthem).

And for a 55-year-old in Hartford County, bronze plans would cost between $440.20 (ConnectiCare) and $501.37 (HealthyCT) per month. Silver plans would range from $551.68 (ConnectiCare) to $633.28 (HealthyCT) per month. And gold plans would cost between $633.45 (ConnectiCare) and $664.45 (Anthem) each month.

Those rates don’t account for discounts that will be available to many people who buy coverage through the exchange. People with household incomes of less than 400 percent of the poverty level will quality for federal subsidies that will reduce their premiums. To determine if you’d qualify for a discounted rate, click here.

Small groups

The base rates for small-group plans are higher than those on the exchange’s individual market.

For bronze plans, the base rates are: $277.95 for Anthem, $298.05 for HealthyCT, and $271.91 for UnitedHealthcare.

For silver plans, the base rates are $351.42 for Anthem, $340.96 for HealthyCT, and $361.26 for UnitedHealthcare.

For gold plans, the base rates are $407.32 for Anthem, $390.05 for HealthyCT, and $435.72 for UnitedHealthcare.

All the filings are available at the Connecticut Insurance Department’s website.

Going up or down?

Will people be paying more or less than they do now? Like much about the rates, it depends.

The new plans must cover more benefits than some plans that are currently available, raising the costs.

There are also new rules about how plan prices are set. Men and women can’t be charged different rates, as they currently are, something that currently benefits younger men and older women. In addition, the oldest people buying coverage can’t be charged more than three times what young people pay. In today’s market, older customers can pay five to six times more than younger ones.

The health reform law also prohibits insurers from denying people coverage, or charging them more based on their medical history. For people who have previously been shut out of coverage, or required to buy it through a high-risk pool, that could mean lower rates. But for healthy people who benefitted from a selective insurance pool in the past, the costs could be higher.

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Follow The Mirror's coverage of the Affordable Care Act in Connecticut. Find features, explainers and Q&As to better understand how the complex policy changes taking place under Obamacare are supposed to work in theory, and how they're working out in practice.

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